A New Method of Subretinal Injection of Tissue Plasminogen Activator and Air in Patients With Submacular Hemorrhage

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Subretinal macular hemorrhage (SRMH) is an important cause of irreversible visual loss1 because it causes permanent functional and anatomical damage to photoreceptors, mainly as a result of 1) barrier effect (separation of photoreceptors from the retinal pigmented epithelium by the blood), 2) tractional changes (clot contraction causing sharing of the photoreceptors),2 and 3) toxic damage (hemosiderin from hemoglobin is toxic to the photoreceptors).3 In fact, Litts et al4 demonstrated histologically that cones overlying an SRMH become degenerated, with translocated mitochondria.
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